Lin Jiangtao, Gao Jie, Lai Kefang, Zhou Xin, He Bei, Zhou Jianying, Wang Changzheng
China-Japan Friendship Hospital, Beijing, China.
Department of Outcomes Research, MSD China, Shanghai, China.
PLoS One. 2018 Feb 22;13(2):e0191543. doi: 10.1371/journal.pone.0191543. eCollection 2018.
Asthma affects a large number of patients in China, but comprehensive evaluation of risks associated with poor asthma control in asthmatic patients with nasal diseases was still limited. We conducted this study to provide a comprehensive estimate of asthma control in Chinese asthma patients with combined nasal diseases, to explore the effect of kinds of nasal diseases on the asthma control, and to identify risk factors associated with uncontrolled asthmatic patients with combined nasal diseases. 1756 asthma patients concomitant with nasal diseases aged ≥17 years and representing all regions of mainland China were surveyed. Multivariate logistic regression model with all related demographic characteristics and disease characteristics factors entered was used to identify risk factors associated with uncontrolled asthma. 56.4% of asthmatic patients with combined allergic rhinitis or rhinosinusitis or rhinopolyp remained uncontrolled. Concomitant without allergic rhinitis, younger age, better treatment adherence and higher education level might positively impact asthma control among asthmatic patients with combined nasal diseases. Perennial allergic rhinitis (OR = 1.5, P = 0.021), moderate-severe allergic rhinitis (OR = 2.2, P = 0.001) were all found to significantly increase the risk of uncontrolled asthma among asthma patients with combined allergic rhinitis. The high prevalence of uncontrolled asthma indicates that asthma management among adult Chinese asthmatic patients comorbid with nasal disease is still a challenge. Efforts should be made to raise the awareness of asthma management and to provide sufficient treatment will greatly contribute to improved quality of asthma management. It is possible to minimize the influence of allergic rhinitis on asthma control by improving nasal function, especially for more severe allergic rhinitis and perennial allergic rhinitis.
哮喘在中国影响着大量患者，但对于合并鼻部疾病的哮喘患者中与哮喘控制不佳相关风险的综合评估仍然有限。我们开展这项研究，旨在全面评估合并鼻部疾病的中国哮喘患者的哮喘控制情况，探讨各类鼻部疾病对哮喘控制的影响，并确定合并鼻部疾病的未控制哮喘患者的相关危险因素。对1756例年龄≥17岁、来自中国大陆所有地区且合并鼻部疾病的哮喘患者进行了调查。采用纳入所有相关人口统计学特征和疾病特征因素的多变量逻辑回归模型来确定与未控制哮喘相关的危险因素。56.4%合并变应性鼻炎、鼻窦炎或鼻息肉的哮喘患者仍未得到控制。在合并鼻部疾病的哮喘患者中，未合并变应性鼻炎、年龄较小、治疗依从性较好以及教育水平较高可能对哮喘控制产生积极影响。在合并变应性鼻炎的哮喘患者中，常年性变应性鼻炎（比值比[OR]=1.5，P=0.021）、中重度变应性鼻炎（OR=2.2，P=0.001）均被发现会显著增加未控制哮喘的风险。未控制哮喘的高患病率表明，中国成年合并鼻部疾病的哮喘患者的哮喘管理仍然是一项挑战。应努力提高哮喘管理意识，提供充分治疗将极大有助于改善哮喘管理质量。通过改善鼻功能，有可能将变应性鼻炎对哮喘控制的影响降至最低，尤其是对于更严重的变应性鼻炎和常年性变应性鼻炎。
